Provider Demographics
NPI:1275258329
Name:SADEK, PETER S (RPH)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:S
Last Name:SADEK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 FONTANA CIR APT 203
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-5536
Mailing Address - Country:US
Mailing Address - Phone:407-617-1401
Mailing Address - Fax:
Practice Address - Street 1:410 FONTANA CIR APT 203
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-5536
Practice Address - Country:US
Practice Address - Phone:407-617-1401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS64851183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist